Vocal Biomarker Assessment Following Pediatric Traumatic Brain Injury: A Retrospective Cohort Study

Recommendations following pediatric traumatic brain injury (TBI) support the integration of instrumental measurement to aid perceptual assessment in recovery and treatment plans. A comprehensive set of sensitive, robust and non-invasive measurements is therefore essential in assessing variations in speech characteristics over time following pediatric TBI. In this paper, we discuss a method for measuring changes in the speech patterns of a pediatric cohort of ten subjects diagnosed with severe TBI. We apply a diverse set of both well-known and novel feature measurements to child speech recorded throughout the year following diagnosis. We analyze these features individually and by speech subsystem for each subject as well as for the entire cohort. In children older than 72 months, we find highly significant (p < 0.01) increases in pitch variation and number of unique phonemes spoken, shortened pause length, and steadying articulation rate variability. Younger children exhibit similar steadied rate variability alongside an increase in articulation complexity. Nearly all speech features significantly change ( p < 0.05) for the cohort as a whole, confirming that acoustic measures expanding upon perceptual assessment are needed to identify efficacious treatment targets for speech therapy following TBI.(1)